| NPI | 1073306890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 170300000X Genetic Counselor, MS | |
| Enumeration Date | 2025-05-24 |
| Last Update Date | 2025-05-24 |